MEDICARE: ABIOLA B ALABI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	122191	MN

General Provider Information

NPI Number	:	1982219424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIOLA B ALABI

Provider Business Mailing Address
First Line	:	4005 VINEWOOD LN N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55442-1734
Country	:	US
Telephone Number	:	763-553-9731
Fax Number	:	763-553-9144

Provider Business Practice Location Address
First Line	:	4005 VINEWOOD LN N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55442-1734
Country	:	US
Telephone Number	:	763-553-9731
Fax Number	:	763-553-9144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	09/11/2020

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Directions to “ ABIOLA B ALABI ” Practice Location

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